Grace Smith

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

905572 Issued in MS

Practice address

208 Key Dr Ste C
Madison, MS 39110-7378

Phone

(601) 760-2050

NPI assigned

Oct 27, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vitality CounselingGroup PAC ID 3577954650, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Vitality Counseling

  • Professional Counselor
  • Madison, MS
  • NPI 1154904035
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1666828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666828800000",
    "number": "1982311122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 KEY DR",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391107378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 KEY DR STE C",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391107378",
            "telephone_number": "601-760-2050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "GRACE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-27",
        "last_updated": "2022-10-27",
        "certification_date": "2022-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MS",
            "license": "905572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyler Slay, LPC
• Sleepworks, Inc.
• Smartsmile Orthodontics, PLLC
• Amerial Smith
• Derrick Brice Smith, DPT
• Jasmine Martin Smith, PT, DPT
• Keith Letiste Smith, PHARMD
• Philip C Smith, M.D.
• Richard L. Smith, DMD
• William H. Smith Jr., M.D.

• Psychiatric/Mental Health Nurse Practitioner in Madison, MS
• Providers in Madison, MS by specialty
• Psychiatric/Mental Health Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.